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Nerve & Numbness · Peripheral Neuropathy

That burning, tingling feeling in your feet or hands.

Peripheral neuropathy is nerve damage that causes burning, numbness, or tingling — most often starting in the feet and working upward. It can feel relentless, especially at night, but there are real treatments that calm the pain and slow the progression for most people.

Your doctor may call this peripheral nerve damage or polyneuropathy.

Often seen within a few days — sometimes as soon as tomorrow

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30min
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15min
Follow-up

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What's actually happening

What peripheral neuropathy really is.

Your peripheral nerves are the communication cables connecting your brain and spinal cord to everything else — your feet, hands, skin, and organs. When those cables are damaged, the signals they carry get scrambled: you may feel burning where there's nothing hot, numbness where you're being touched, or sharp jolts of pain seemingly out of nowhere.

The causes are wide-ranging. Diabetes is the most common in the U.S., but alcohol use, vitamin deficiencies, certain medications, autoimmune conditions, and sometimes unknown factors can all damage peripheral nerves. That's why pinning down the cause matters — treating it well requires understanding why it's happening.

The good news

Most peripheral neuropathy is manageable, and when an underlying cause is found and treated early, nerve damage can often be slowed — sometimes significantly. Pain relief is achievable for the majority of patients even when full reversal isn't possible. You don't have to just live with it.

The clinical picture

Length-dependent vs. focal neuropathy

Most peripheral neuropathy follows a 'length-dependent' pattern — longer nerves are affected first, so symptoms start at the feet and move upward. We evaluate distribution, fiber type (large vs. small), and electrodiagnostic findings to classify the pattern and guide treatment. That classification shapes everything from medication choice to whether additional workup is warranted.

How it feels

Common signs we treat.

Burning in the feet or hands

A persistent burning sensation — often worse at night — that can range from a mild warmth to an intense, distracting heat.

Tingling or pins and needles

A constant or intermittent prickling feeling, as if the affected area has 'fallen asleep' and won't fully wake up.

Numbness or loss of sensation

Areas of the feet, toes, or hands that feel deadened — making it harder to sense temperature, pressure, or injury.

How we treat peripheral neuropathy

From hurting to healed.

We work from the least-invasive options upward, escalating only if you need it. Most patients improve well before surgery is ever discussed.

Step 1

Diagnose the cause

A physician examines you and, if needed, reviews imaging to pinpoint exactly what's driving the pain.

Step 2

Calm it down

Targeted physical therapy, activity guidance, and medication to settle the irritation and reduce inflammation.

Step 3

Image-guided injections

If pain persists, a precisely targeted injection delivered to the source under imaging.

Step 4

Advanced options

For the few who need more, minimally invasive interventional procedures — with surgery as a last resort.

Treatment is matched to your specific diagnosis at your visit. The options shown reflect NASPAC's general approach and should be confirmed against the practice's verified procedure list.

Common questions

Still have questions?

The most common cause is diabetes, but peripheral neuropathy can also result from alcohol use, certain chemotherapy drugs, vitamin B12 deficiency, thyroid problems, autoimmune conditions like lupus, and infections. In some cases, no cause is found — called idiopathic neuropathy. Identifying the cause is the starting point for effective treatment.

Whether neuropathy can be reversed depends on the cause and how early it's caught. Neuropathy from a correctable cause — like B12 deficiency or alcohol use — can improve significantly when that cause is addressed. Diabetic neuropathy can often be slowed or stabilized with better blood sugar control. True reversal of long-standing damage is less predictable, but meaningful pain relief is achievable for most people.

Treatment usually combines addressing the underlying cause with medications to calm nerve pain — such as gabapentinoids, certain antidepressants, or topical agents. For patients who don't respond to those, we explore interventional options including nerve blocks or spinal cord stimulation. Physical therapy and foot care are important parts of the overall plan as well.

Several factors make neuropathic pain flare at night: fewer distractions let you focus on the sensation, lying still slows circulation, and body temperature drops slightly which can heighten nerve sensitivity. Managing nighttime pain is one of the most important quality-of-life goals in neuropathy treatment, and there are specific strategies that help.

Stop living with the burning and numbness.

Book with a board-certified pain physician near you — most patients are seen within days.

Book an appointment → Or call (855) 862-7767